Immigration Medical Exam: What to Expect and Tips

The I-693 Medical Exam: What You Need to Know

Every green card applicant must complete the I-693 medical examination performed by a USCIS-designated civil surgeon. This is a non-negotiable requirement whether you are filing through adjustment of status or consular processing. Here is exactly what to expect so you can walk in prepared.

What the Doctor Checks

The civil surgeon performs a standard physical examination including height, weight, blood pressure, and vital signs. They check for physical and mental health conditions that could make you inadmissible, including tuberculosis (mandatory TB test via blood test or chest X-ray), syphilis (blood test), and gonorrhea. They also review your vaccination history and administer any required vaccinations you are missing.

Required Vaccinations for Green Card

USCIS requires all age-appropriate vaccinations from the CDC schedule. For adults, this typically includes: MMR (measles, mumps, rubella), varicella (chickenpox), tetanus/diphtheria/pertussis (Tdap), polio, hepatitis A, hepatitis B, influenza (seasonal), COVID-19, pneumococcal, and meningococcal. If you already have records showing previous vaccinations, bring them — it saves money and avoids unnecessary duplicate shots.

How Much It Costs

The medical exam itself costs $200 to $500 depending on the civil surgeon and location. Vaccinations are additional and can add $100 to $500 if you need multiple shots. Some civil surgeons offer package deals. This cost is NOT reimbursed by USCIS and is separate from all filing fees. See our breakdown in Hidden Costs of Immigration.

Tips for a Smooth Exam

Bring your vaccination records, passport, I-94, and a government-issued photo ID. Wear short sleeves for blood draws. If you take prescription medications, bring the bottles. The exam results (sealed Form I-693) are valid for 2 years from the date of the civil surgeon's signature. Do NOT open the sealed envelope — submit it sealed with your I-485.

When to Work with an Immigration Attorney

Not every immigration question needs a lawyer, but some do. The topics covered in this article include situations where a brief consultation with a licensed U.S. immigration attorney can save months of delay, prevent irreversible mistakes, and identify options you might not otherwise know about. Consider consulting an attorney if your case involves any of the following:

• Criminal history of any kind. Even dismissed charges, expunged records, or decades-old offenses can affect immigration outcomes. The immigration consequences of a criminal record are technical and fact-specific, and plea deals that seemed favorable in criminal court sometimes have devastating immigration consequences.
• Past immigration violations or denials. Prior visa denials, overstays, periods of unlawful presence, and prior removal proceedings all affect current options. An attorney can review your history and identify which paths remain open.
• Complicated family situations. Divorce, death of a petitioner, domestic abuse, and similar circumstances can trigger waiver eligibility or affect existing petitions in ways that require careful legal analysis.
• Business immigration matters. Employment-based cases, investor visas, and self-petitions are typically too complex for do-it-yourself filing. The evidentiary standards are demanding and the stakes are high.
• Cases that feel stuck. If your case has been sitting without action for a long time, or if you received an RFE or NOID you do not fully understand, an attorney can diagnose the problem and respond effectively.
• Anything you do not fully understand. Immigration forms are technical, and a small mistake can cascade into large consequences. When in doubt, ask someone qualified.

Finding Reliable Information

The single most reliable source of current U.S. immigration information is USCIS itself. USCIS publishes form instructions, fee schedules, processing times, policy manuals, and policy alerts at uscis.gov. When any article (including this one) references specific fees, processing times, or eligibility rules, the information can become outdated as USCIS updates its policies and fee schedules. Always verify any time-sensitive detail directly with USCIS before filing anything.

Other reliable primary sources include the U.S. Department of State (for visa bulletins and consular processing), the U.S. Department of Labor (for PERM and prevailing wage information), U.S. Customs and Border Protection (for admission and port of entry rules), and the Executive Office for Immigration Review (for immigration court procedures).

Secondary sources — including practitioner guides, law school immigration clinics, and reputable nonprofit legal aid organizations — can provide helpful explanations of how the rules apply in practice. Community forums and social media should be treated with caution: they can point you to useful resources, but they also contain a great deal of inaccurate or outdated information, and the rules change frequently enough that what was true a year ago may not be true now.

Keeping Records

One of the simplest ways to protect yourself through any immigration process is to keep careful records of everything. Copies of every filing you send to USCIS, every notice you receive, every check or money order you submit, and every piece of correspondence you send or receive become critical evidence if something goes wrong later. Keep these records organized, dated, and backed up in at least two separate places (for example, a physical folder and a digital scan).

Also keep records of everything that supports your underlying eligibility — tax returns, marriage certificate, birth certificates, medical records, employment records, property records, school transcripts, and anything else that demonstrates ties to the United States, family relationships, or program eligibility. Good records are the backbone of a strong immigration case.

When to Work with an Immigration Attorney

Not every immigration question needs a lawyer, but some do. The topics covered in this article include situations where a brief consultation with a licensed U.S. immigration attorney can save months of delay, prevent irreversible mistakes, and identify options you might not otherwise know about. Consider consulting an attorney if your case involves any of the following:

• Criminal history of any kind. Even dismissed charges, expunged records, or decades-old offenses can affect immigration outcomes. The immigration consequences of a criminal record are technical and fact-specific, and plea deals that seemed favorable in criminal court sometimes have devastating immigration consequences.
• Past immigration violations or denials. Prior visa denials, overstays, periods of unlawful presence, and prior removal proceedings all affect current options. An attorney can review your history and identify which paths remain open.
• Complicated family situations. Divorce, death of a petitioner, domestic abuse, and similar circumstances can trigger waiver eligibility or affect existing petitions in ways that require careful legal analysis.
• Business immigration matters. Employment-based cases, investor visas, and self-petitions are typically too complex for do-it-yourself filing. The evidentiary standards are demanding and the stakes are high.
• Cases that feel stuck. If your case has been sitting without action for a long time, or if you received an RFE or NOID you do not fully understand, an attorney can diagnose the problem and respond effectively.
• Anything you do not fully understand. Immigration forms are technical, and a small mistake can cascade into large consequences. When in doubt, ask someone qualified.

Finding Reliable Information

The single most reliable source of current U.S. immigration information is USCIS itself. USCIS publishes form instructions, fee schedules, processing times, policy manuals, and policy alerts at uscis.gov. When any article (including this one) references specific fees, processing times, or eligibility rules, the information can become outdated as USCIS updates its policies and fee schedules. Always verify any time-sensitive detail directly with USCIS before filing anything.

Other reliable primary sources include the U.S. Department of State (for visa bulletins and consular processing), the U.S. Department of Labor (for PERM and prevailing wage information), U.S. Customs and Border Protection (for admission and port of entry rules), and the Executive Office for Immigration Review (for immigration court procedures).

Secondary sources — including practitioner guides, law school immigration clinics, and reputable nonprofit legal aid organizations — can provide helpful explanations of how the rules apply in practice. Community forums and social media should be treated with caution: they can point you to useful resources, but they also contain a great deal of inaccurate or outdated information, and the rules change frequently enough that what was true a year ago may not be true now.

Keeping Records

One of the simplest ways to protect yourself through any immigration process is to keep careful records of everything. Copies of every filing you send to USCIS, every notice you receive, every check or money order you submit, and every piece of correspondence you send or receive become critical evidence if something goes wrong later. Keep these records organized, dated, and backed up in at least two separate places (for example, a physical folder and a digital scan).

Also keep records of everything that supports your underlying eligibility — tax returns, marriage certificate, birth certificates, medical records, employment records, property records, school transcripts, and anything else that demonstrates ties to the United States, family relationships, or program eligibility. Good records are the backbone of a strong immigration case.

When to Work with an Immigration Attorney

Not every immigration question needs a lawyer, but some do. The topics covered in this article include situations where a brief consultation with a licensed U.S. immigration attorney can save months of delay, prevent irreversible mistakes, and identify options you might not otherwise know about. Consider consulting an attorney if your case involves any of the following:

• Criminal history of any kind. Even dismissed charges, expunged records, or decades-old offenses can affect immigration outcomes. The immigration consequences of a criminal record are technical and fact-specific, and plea deals that seemed favorable in criminal court sometimes have devastating immigration consequences.
• Past immigration violations or denials. Prior visa denials, overstays, periods of unlawful presence, and prior removal proceedings all affect current options. An attorney can review your history and identify which paths remain open.
• Complicated family situations. Divorce, death of a petitioner, domestic abuse, and similar circumstances can trigger waiver eligibility or affect existing petitions in ways that require careful legal analysis.
• Business immigration matters. Employment-based cases, investor visas, and self-petitions are typically too complex for do-it-yourself filing. The evidentiary standards are demanding and the stakes are high.
• Cases that feel stuck. If your case has been sitting without action for a long time, or if you received an RFE or NOID you do not fully understand, an attorney can diagnose the problem and respond effectively.
• Anything you do not fully understand. Immigration forms are technical, and a small mistake can cascade into large consequences. When in doubt, ask someone qualified.

Finding Reliable Information

The single most reliable source of current U.S. immigration information is USCIS itself. USCIS publishes form instructions, fee schedules, processing times, policy manuals, and policy alerts at uscis.gov. When any article (including this one) references specific fees, processing times, or eligibility rules, the information can become outdated as USCIS updates its policies and fee schedules. Always verify any time-sensitive detail directly with USCIS before filing anything.

Other reliable primary sources include the U.S. Department of State (for visa bulletins and consular processing), the U.S. Department of Labor (for PERM and prevailing wage information), U.S. Customs and Border Protection (for admission and port of entry rules), and the Executive Office for Immigration Review (for immigration court procedures).

Secondary sources — including practitioner guides, law school immigration clinics, and reputable nonprofit legal aid organizations — can provide helpful explanations of how the rules apply in practice. Community forums and social media should be treated with caution: they can point you to useful resources, but they also contain a great deal of inaccurate or outdated information, and the rules change frequently enough that what was true a year ago may not be true now.

Keeping Records

One of the simplest ways to protect yourself through any immigration process is to keep careful records of everything. Copies of every filing you send to USCIS, every notice you receive, every check or money order you submit, and every piece of correspondence you send or receive become critical evidence if something goes wrong later. Keep these records organized, dated, and backed up in at least two separate places (for example, a physical folder and a digital scan).

Also keep records of everything that supports your underlying eligibility — tax returns, marriage certificate, birth certificates, medical records, employment records, property records, school transcripts, and anything else that demonstrates ties to the United States, family relationships, or program eligibility. Good records are the backbone of a strong immigration case.